| NPI | 1407479777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4351046335) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4351046335) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-05-21 |